CMS Price Transparency Data

X-ray, lower back

Facility: Holy Family Memorial

Billing Code: 72110 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$100
about 0.9× the $107 Medicare rate · typically $100–$173
modeled estimate · not a bill or quote
What this hospital charges insurers
$101
About the fair price
about $1 over the fair price · 0.9× Medicare
Medicare pays $107 Fair price $100 This hospital $101 Cash price $285 Hospital's list price $519

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

Highest price of the 9 WI hospitals we have prices for — worth calling around.

Cheapest $37 Priciest $101

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

A fair price for a X-ray, lower back is about $100 (about 0.9× the $107 Medicare rate). Holy Family Memorial charges insurers about $101, or about $285 in cash — about the fair price. Located in Manitowoc, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Cigna✓ Humana AetnaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $101 - $597 95%
Blue Cross Blue Shieldmajor $66 - $101 62%
Cignamajor $374 350%
Humanamajor $101 95%
Dean Health Plan $260 243%
Health Net $311 291%
HealthPartners $101 - $337 95%
Molina $101 - $109 95%
Security Health Plan $101 - $415 95%
+ 13 smaller / regional plans $101 - $415
Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 2300 Western Ave, Manitowoc, WI 54221
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals